复合TCI异丙酚时舒芬太尼抑制SLIPA喉罩置入反应的半数有效效应室靶浓度

Half-effective target effect-site concentration of sufentanil inhibiting responses to insertion of SLIPAwhen combined with propofol given by target-controlled infusion

目的确定复合TCI异丙酚时舒芬太尼抑制SLIPA喉罩置入反应的半数有效效应室靶浓度（EC50）。 方法拟行宫腔镜手术患者28例，年龄35～55岁，BMI〈30 kg/m2，ASA分级Ⅰ或Ⅱ级。TCI舒芬太尼4 min时开始TCI异丙酚，效应室靶浓度4 μg/ml。待患者意识消失（BIS值〈60），且两种药物都达到相应效应室靶浓度后，置入SLIPA喉罩。采用序贯法，根据患者是否发生喉罩置入反应确定舒芬太尼的效应室靶浓度，初始靶浓度为0.3 ng/ml，相邻靶浓度之比为1.1。采用Dixon-Mood公式计算舒芬太尼抑制SLIPA喉罩置入反应的EC50及其95%可信区间。 结果舒芬太尼抑制SLIPA喉罩置入反应的EC50为0.17 ng/ml，95%可信区间为0.15～0.19 ng/ml。 结论复合TCI异丙酚（效应室靶浓度4 μg/ml）时，舒芬太尼抑制SLIPA喉罩置入反应的EC50为0.17 ng/ml。

Objective To determine the half-effective target effect-site concentration （ECso） of sufentanil inhibiting responses to insertion of Streamlined Liner of the Pharynx Airway （SLIPA） when com- bined with propofol given by target-controlled infusion （TCI）. Methods Twenty-eight patients, aged 35- 55 yr, with body mass index〈30 kg/m2 , of American Society of Anesthesiologists physical status I or II , scheduled for elective hysteroscopic surgery, were selected. Sufentanil was administered by TCI at a con- centration for 4 rain, and then propofol was given by TCI at a target effect-site concentration of 4μg/ml. When the patients lost consciousness （bispectral index value〈60） and the corresponding target effect-site concentrations of two drugs were achieved, SLIPA was inserted. Using the up-and-down sequential trial, the target effect-site concentration of sufentanil was determined according to patient＇s responses to SLIPA in- sertion. The initial target effect-site concentration of sufentanil was 0.3 ng/ml, and the ratio between the two successive concentrations was 1. 1. The ECs0 and 95% confidence interval of sufentanil inhibiting re- sponses to SLIPA insertion were calculated by using Dixon-Mood formula. Results The ECs0 of sufentanil inhibiting responses to SLIPA insertion was 0. 17 ng/ml, and the 95% confidence interval was 0. 15-0. 19 ng/ml. Conclusion When combined with propofol （target effect-site concentration 4 μg/ml） given by TCI the EC 50 of sufentanil inhibiting responses to SLIPA insertion is 0. 17 ng/ml.